Provider Demographics
NPI:1225173784
Name:VIEDERMAN, MILTON (MD)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:
Last Name:VIEDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SUTTON PLACE SOUTH
Mailing Address - Street 2:SUITE 1CN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-308-2179
Mailing Address - Fax:212-308-2307
Practice Address - Street 1:60 SUTTON PLACE SOUTH
Practice Address - Street 2:SUITE 1CN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-308-2179
Practice Address - Fax:212-308-2307
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0852192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B16011Medicare UPIN